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Likelihood ratios for glaucoma diagnosis using spectral-domain optical coherence tomography.

Publication ,  Journal Article
Lisboa, R; Mansouri, K; Zangwill, LM; Weinreb, RN; Medeiros, FA
Published in: Am J Ophthalmol
November 2013

PURPOSE: To present a methodology for calculating likelihood ratios for glaucoma diagnosis for continuous retinal nerve fiber layer (RNFL) thickness measurements from spectral-domain optical coherence tomography (spectral-domain OCT). DESIGN: Observational cohort study. METHODS: A total of 262 eyes of 187 patients with glaucoma and 190 eyes of 100 control subjects were included in the study. Subjects were recruited from the Diagnostic Innovations Glaucoma Study. Eyes with preperimetric and perimetric glaucomatous damage were included in the glaucoma group. The control group was composed of healthy eyes with normal visual fields from subjects recruited from the general population. All eyes underwent RNFL imaging with Spectralis spectral-domain OCT. Likelihood ratios for glaucoma diagnosis were estimated for specific global RNFL thickness measurements using a methodology based on estimating the tangents to the receiver operating characteristic (ROC) curve. RESULTS: Likelihood ratios could be determined for continuous values of average RNFL thickness. Average RNFL thickness values lower than 86 μm were associated with positive likelihood ratios (ie, likelihood ratios greater than 1), whereas RNFL thickness values higher than 86 μm were associated with negative likelihood ratios (ie, likelihood ratios smaller than 1). A modified Fagan nomogram was provided to assist calculation of posttest probability of disease from the calculated likelihood ratios and pretest probability of disease. CONCLUSION: The methodology allowed calculation of likelihood ratios for specific RNFL thickness values. By avoiding arbitrary categorization of test results, it potentially allows for an improved integration of test results into diagnostic clinical decision making.

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Published In

Am J Ophthalmol

DOI

EISSN

1879-1891

Publication Date

November 2013

Volume

156

Issue

5

Start / End Page

918 / 926.e2

Location

United States

Related Subject Headings

  • Visual Fields
  • Visual Acuity
  • Tomography, Optical Coherence
  • Retinal Ganglion Cells
  • ROC Curve
  • Optic Nerve Diseases
  • Ophthalmology & Optometry
  • Nerve Fibers
  • Middle Aged
  • Male
 

Citation

APA
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ICMJE
MLA
NLM
Lisboa, R., Mansouri, K., Zangwill, L. M., Weinreb, R. N., & Medeiros, F. A. (2013). Likelihood ratios for glaucoma diagnosis using spectral-domain optical coherence tomography. Am J Ophthalmol, 156(5), 918-926.e2. https://doi.org/10.1016/j.ajo.2013.06.017
Lisboa, Renato, Kaweh Mansouri, Linda M. Zangwill, Robert N. Weinreb, and Felipe A. Medeiros. “Likelihood ratios for glaucoma diagnosis using spectral-domain optical coherence tomography.Am J Ophthalmol 156, no. 5 (November 2013): 918-926.e2. https://doi.org/10.1016/j.ajo.2013.06.017.
Lisboa R, Mansouri K, Zangwill LM, Weinreb RN, Medeiros FA. Likelihood ratios for glaucoma diagnosis using spectral-domain optical coherence tomography. Am J Ophthalmol. 2013 Nov;156(5):918-926.e2.
Lisboa, Renato, et al. “Likelihood ratios for glaucoma diagnosis using spectral-domain optical coherence tomography.Am J Ophthalmol, vol. 156, no. 5, Nov. 2013, pp. 918-926.e2. Pubmed, doi:10.1016/j.ajo.2013.06.017.
Lisboa R, Mansouri K, Zangwill LM, Weinreb RN, Medeiros FA. Likelihood ratios for glaucoma diagnosis using spectral-domain optical coherence tomography. Am J Ophthalmol. 2013 Nov;156(5):918-926.e2.
Journal cover image

Published In

Am J Ophthalmol

DOI

EISSN

1879-1891

Publication Date

November 2013

Volume

156

Issue

5

Start / End Page

918 / 926.e2

Location

United States

Related Subject Headings

  • Visual Fields
  • Visual Acuity
  • Tomography, Optical Coherence
  • Retinal Ganglion Cells
  • ROC Curve
  • Optic Nerve Diseases
  • Ophthalmology & Optometry
  • Nerve Fibers
  • Middle Aged
  • Male